Introduction:
Barium swallow also called an esophagram, is an imaging test that checks for problems in the upper gastrointestinal tract. When barium is swallowed, it coats the lining of the upper gastrointestinal tract. Barium is used to create clear images on an X-ray during a swallowing test. It provides better contrast images. The use of barium sulfate contrast is more sensitive when compared to water-soluble agents such as gastrografin or diatrizoate.
Why Is Barium Used With X-Rays?
Barium sulfate is a dry, white, chalky powder mixed with water to make a barium solution. Barium is an X-ray absorber and looks white on X-ray film. The barium swallow test allows viewing the size and shape of the pharynx and esophagus and the way of swallowing. Barium is used only for diagnostic studies of the gastrointestinal tract.
Why Is a Barium Swallow Test Done?
A barium swallow test is done to diagnose problems of the pharynx and esophagus, including:
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Cancer of the head and neck, pharynx, or esophagus.
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Structural abnormalities such as diverticulum, narrowing of the esophagus, or any polyps.
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Hiatal hernia (in which a part of the stomach pushes into the diaphragm).
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Muscle disorders such as difficulty swallowing or spasms.
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Gastrointestinal reflux disease and ulcers.
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Enlarged veins in the esophagus.
It is used to diagnose the cause of some symptoms like:
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Trouble swallowing.
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Abdominal pain.
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Bloating.
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Vomiting.
How to Prepare for a Barium Swallow Test?
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The patient is advised to stop eating or drinking anything eight hours before the procedure.
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Inform the doctor whether you are pregnant or about to get pregnant before undertaking a barium swallow test.
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Inform the doctor, if you are sensitive or allergic to any medicine, or anesthesia before a swallow test.
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Inform the doctor about your medications, such as vitamin and herbal supplements.
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Inform if you had a recent barium swallow or an upper gastrointestinal series test.
What Happens During the Barium Swallow Procedure?
A radiologist usually performs a barium swallow test. The patient is asked to remove any eyewear, jewelry, or other objects that interfere with the procedure. The patient wears a surgical gown during the procedure. The patient is asked to lie on a table. A barium swallow is an outpatient procedure and does not require sedation or anesthesia. The radiologist first takes standard X-rays of the chest and abdomen. Then the patient is asked to swallow a thick, chalky barium solution. Barium is usually flavored, but it does not taste good.
As the patient swallows barium, the radiologist takes a series of X-rays to watch the barium moving through the mouth and throat. Next, a thinner barium solution is given to swallow, and again X-rays are taken as the barium moves down the esophagus.
The patient is asked to change positions and sometimes to hold their breath during the procedure. The patient may also be asked to swallow a barium pill which can highlight problems in the esophagus. The barium swallow procedure takes about 30 minutes.
What Happens After the Barium Swallow Test?
The patient can continue their normal diet and activities after the barium swallow test. Barium can cause constipation if it is not completely eliminated from the body. The patient is advised to drink plenty of fluids and eat a high-fiber diet to improve constipation symptoms and help remove the remaining barium from the body. The bowel movements can be white or mild in color until all the barium is eliminated.
What Are the Risks of a Barium Swallow Test?
The risk of a barium swallow test includes problems from radiation exposure, intestinal issues, and birth defects. Pregnant women should not undergo a barium swallow test as it may lead to birth defects. A small amount of barium can go into the airway while drinking barium.
Some side effects of barium swallow include:
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Most people complain of nausea or vomiting within 30 minutes of ingestion.
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The trouble with bowel movements or being unable to have a bowel movement or pass gas.
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Pain or swelling of the abdomen.
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Smaller stools than normal.
What Are the Contraindications?
Avoid a barium swallow test in the following conditions:
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Perforation in the esophagus or intestine.
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Blockage in the intestine.
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Severe constipation.
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Problems with swallowing.
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Allergy or sensitivity to medicines, anesthesia, iodine, and contrast dyes.
What Are the Results?
The result can be positive or negative.
Negative Result: There are no abnormalities in the size, shape, and movement of the throat, esophagus, stomach, and first part of the small intestine.
Positive Result: If the result is positive, some abnormalities or conditions are present. If the result is positive, the doctor recommends an endoscopy procedure in which a thin, flexible tube attached to a camera is inserted into the mouth and down into the esophagus. During endoscopy, a tissue sample (biopsy) is also collected for examination in the laboratory.
What Is a Modified Barium Swallow Test?
A modified barium swallow is a test to see what happens when people swallow various types of food or liquids. This test uses a special type of X-ray known as fluoroscopy.
Fluoroscopy is a kind of real-time form of X-ray to help analyze swallowing.
What Is the Difference Between Barium Swallow and Barium Enema?
In barium swallow or barium meal, the barium sulfate powder is mixed with water and then swallowed. X-rays are taken when swallowing the mixture.
In barium enema, the powder is mixed with water and inserted into the rectum through a tube into the large intestine, and X-rays are taken.
Conclusion:
Barium swallows are a useful diagnostic tool for checking upper gastrointestinal tract problems. It is a less invasive procedure than endoscopy. It is generally a safe test with fewer complications. Barium passes through the digestive system and does not cause any harm.
